Table 1 Clinical usage of TNS
From: Trigeminal nerve stimulation: a current state-of-the-art review
Status | Medical Condition | Stimulation Method | Population | Stimulation Parameters | Observations | Adverse Events | Reference |
|---|---|---|---|---|---|---|---|
Clinical Usage | Migraine | Infratrochlear nerve | Healthy, common migraine, episodic CH, and inactive phase of CH | 40 mA 0.8 ms PW | Significant ipsilateral pupillary miosis | None stated | Fanciullacci et al. 1989 |
Subcutaneous supraorbital and occipital nerve | Patients with CM | Not stated | ↓ Pain and neurological symptoms | None stated | Reed et al. 2010 | ||
Bilateral supratrochlear and supraorbital nerves with Cefaly | Migraine with or without aura | 60 Hz 16 mA 0.25 ms PW 20 min/day | ↓ Migraine severity and frequency | None stated | Schoenen et al. 2013 | ||
Cefaly—Transcutaneous Supraorbital Nerve | Chronic Migraine, 60% with medication overuse | 100 Hz 16 mA 0.25 ms Pw | ↓ Muscle EMG | None stated | Didier et al. 2015 | ||
60 Hz 16 mA 0.3 ms PW | |||||||
Cefaly—Transcutaneous Supraorbital Nerve | 67 episodic migraine patients | 60 Hz 16 mA 0.25 ms PW 20 min per day | ↓ Migraine days | Paresthesia reported | Reiderer et al. 2015 | ||
Cefaly supraorbital and supratrochlear stimulation | 24 patients with migraine without aura | 60 Hz 16 mA 0.25 ms PW 20 min/day | ↓ Migraine severity and frequency ↓ HIT-6 questionnaire rating | None stated | Russo et al. 2015 | ||
3 months Cefaly—Transcutaneous Supraorbital Nerve | 28 individuals Episodic Migraine | 60 Hz 16 mA 0.25 ms PW 20 min daily for 3 months | ↓ Migraine days ↓ Hypometabolism in OFC and rACC | None stated | Magis et al. 2017 | ||
Cefaly eTNS | 30 patients diagnosed with migraine with or without aura | 100 Hz 16 mA 0.25 ms PW 60 min/day | ↓ Pain intensity | None stated | Chou et al. 2017 | ||
Cefaly | Chronic migraine | 60 Hz 16 mA 0.25 ms PW 20 min/day | ↓ Frequency ↓ Medication usage | None stated | Di Fiore et al. 2017 | ||
Cefaly—Transcutaneous Supraorbital Nerve | 109 Participants | 100 Hz 16 mA 0.25 ms PW 1 h | ↓ Pain scores | None stated | Chou et al. 2019 | ||
Transcutaneous supraorbital nerve stimulation (Cefaly) | Migraine w/out aura | 60 Hz 16 mA 0.25 ms PW 20 min/day | Strong placebo effect was noted | None stated | Vecchio et al. 2018 | ||
Cefaly on supratrochlear and supraorbital of ophthalmic | Vestibular migraine | 60 Hz 16 mA 0.25 ms PW 20 min/day | ↓ Vertigo and headache ↓ Symptoms | None stated | Beh 2020 | ||
Supraorbital and supratrochlear nerve electrostimulation | 25 participants with CM | 60 Hz 16 mA 0.25 ms PW 20 min/day | ↑ Sleep ↓ Pain severity and frequency | Some paresthesia, unpleasant dysesthesias, mild dizziness, mild nausea, somnolence | Ordas et al. 2020 | ||
Cefaly eTNS | Patients with CM | 100 Hz 16 mA 0.25 ms PW 120 min/day | ↓ Headaches | Only minor AEs, such as paresthesia | Kuruvilla et al. 2019 | ||
Cefaly eTNS | 18 patients with ocular pain with/without CM | 60 Hz 16 mA 0.25 ms PW 20 min/day | ↓ Ocular pain intensity ↓ Light sensitivity ↓ Wind sensitivity ↓ Burning sensation | Sedation | Mehra et al., 2021 | ||
Cefaly eTNS | 24 patients with CM | 60 Hz 16 mA 0.25 ms PW 20 min/day | ↓ Headache days | None stated | Trimboli et al. 2023 | ||
pediatric ADHD | 8-week NeuroSigma Monarch eTNS – bipolar V1 stimulation | Adolescents aged 7–14 with DSM IV ADHD | 120 Hz 0.25 ms PW 30 s on 30 s off 7 – 9 h per night | ↓ Inattentive and hyperactivity ↑ Height, weight, pulse | None stated | McGough et al. 2019 | |
Balance difficulties due to mTBI | Helius Medical PONS-Translingual eTNS | Adults | Not stated | ↓ SOT, DGI, and 6MWT scores | 2 mild and 6 moderate AEs | Tyler et al 2019 | |
Translingual neurostimulation | Adults with mTBI diagnosis and balance deficit | High Freq: 150 Hz 0.4—60 µs PW 5 ms interval | ↑ DGI scores ↓ HDI and SQI | None stated | Ptito et al. 2021 | ||
Low Freq: 0.08 Hz 12.5 s interval | |||||||
Clinical Trials/ Testing | Drug Resistant Epilepsy | Unspecified | 2 patients | 120 Hz 8 – 25 mA 20 – 30 s on 20 – 30 s off 24 h | ↓ Seizures | None stated | DeGiorgio et al. 2003 |
NeuroSigma Monarch eTNS – bipolar stimulation at ophthalmic and supratrochlear nerves | Patients with 2 or more partial onset seizures per month | 120 Hz 0.25 ms PW | ↓ In seizure frequency Mood improvement | Anxiety, headache, and skin irritation | DeGiorgio et al. 2013 | ||
Patients with DRE | 120 Hz 7/30 s > 8 h/day | ↑ Quality of life | No severe adverse events | Slaght et al. 2017 | |||
Patients with DRE, use of at least 1 AED | Not stated | ↑ Sleep, mood, and energy ↓ Seizures | None stated | Olivie et al. 2019 | |||
Patients with DRE | 120 Hz < 10 mA 0.25 ms PW 30 s on 30 s off At least 8 h/day | ↑ Quality of life ↓ Seizure rates | No severe adverse events | Gil-Lopez et al. 2020 | |||
Unspecified | Patient with DRE which progressed to RSE | None stated | Improved mental status ↓ Seizures | No severe AE | Moseley et al. 2014 | ||
APEX set for neuromodulation | Patients with DRE | 120 Hz 0.25 ms PW 5 s on 5 s off | ↓ Seizures | No severe AE | Zare et al. 2014 | ||
Winner stimulator | 29 subjects with DRE | 120 Hz 1 – 20 mA 0.25 ms PW 30 s on 30 s off 20 min | ↑ Absolute power of alpha band in the parietal-occipital areas | None stated | Ginatempo et al. 2019 | ||
Depression | 8 weeks external trigeminal nerve stimulation (NeuroSigma predecessor) | Pharmacological resistant major depression | Not stated | ↓ HDRS and BDI scores | None stated | Schrader et al 2011 | |
NeuroSigma Monarch eTNS | Adults with nonpsychotic unipolar MDD | 120 Hz 4 – 6 mA 0.25 ms PW 30 s on 30 s off | ↑ Quality of life ↓ Depression test scores | No severe adverse events | Cook et al 2013 | ||
Patients diagnosed with MDD | 120 Hz 0 – 100 mA 0.25 ms PW Cycle of 30 s | ↓ Depression test scores | No severe adverse events | ||||
10 Days Ibramed Neurodyn eTNS- V1 TENS stimulation | Patients between 18 and 69 with severe MDD | 120 Hz 0 – 100 mA 0.25 ms PW Cycle of 30 s | ↓ Depressive symptoms | None stated | Generoso et al 2019 | ||
Fibromyalgia | 10 days of bilateral supraorbital stimulation | Patient with fibromyalgia | 120 Hz 0.25 ms PW 30 min | ↓ Pain ↓ Depressive symptoms | None stated | ||
Social Anxiety Disorder (SAD) | 10 days supraorbital electrostimulation | Patient with SAD | 120 Hz 0.25 ms PW 30 min continuous | ↓ Avoidance behaviors ↓ SPIN and LSAS scores | None stated | Trevizol et al. 2015 | |
PTSD | Bilateral trigeminal nerve electrostimulation | 5 patients with PTSD and MDD | 120 Hz 0.25 ms PW 30 min/day | ↓ PTSD and depressive symptoms | No serious AE reported | Trevizol et al 2015 | |
NeuroSigma Monarch eTNS | Adults with both PTSD and MDD, 18–75 in age | 120 Hz 4 – 6 mA 0.25 ms PW 30 s on 30 s off 8 h each night | ↓ PCL score | None stated | Cook et al 2016 | ||
Cognitive/ Sensory Dysfunction Secondary to Other Pathologies | Portable Neuromodulation Stimulator (PoNS™) | 14 MS patients | Not stated | ↑ SOT scores ↑ BOLD in bilateral premotor areas | None stated | Leonard et al. 2017 | |
EA/TNS for 15 acupoints (some on trigeminal facial nerves) | Females 18–65 with breast cancer, either undergoing or finished chemo less than 2 weeks ago | 2 Hz 6 V, 48 mA 0.1 ms PW 30 min | ↓ Diarrhea, tenseness, worriness, irritation, headache, and tinnitus | None stated | Zhang et al. 2020 | ||
Persistent Vegetative State | Ophthalmic nerve and maxillary nerve | Patients in PVS | 40 Hz 18 – 20 mA 0.2 ms PW 30 s/min 6 h/day | Spontaneous eye opening and exclamatory articulated speech after 4 weeks of TNS ↑ GCS scores | None stated | Fan et al. 2019 | |
Suborbital foramen and bilateral superior orbital fissures | Patients with Disorders of Consciousness | 40 Hz 18 – 20 mA 200 ms PW 30 s/min | Signs of recovery | None stated | Dong et al. 2022 | ||
Bilateral maxillary and mandibular nerve | Patients with DOC after suffering TBI | 40/28 Hz 8 mA 40 min | ↑ CRS-R scores | None stated | Wu et al. 2022 | ||
Bilateral supraorbital foramen and infraorbital foramen | Patients in PVS | 40 Hz 10 – 15 mA 0.2 ms PW 30 s/min 3 h/day | ↑ Recovery ↑ Total GCS and CRS-S scores ↓ Hypometabolic areas | None stated | Ma et al. 2023 | ||
Subarachnoid Hemorrhage | Supratrochlear and supraorbital transcutaneous electrical stimulation | Patients with SAH | 20 Hz 14 days Continuous | No significant effects on vasospasm-related DCI, functional outcome, and health-related quality of life | None stated | Rigoard et al. 2023 | |
Parkinson’s Disease | Gaseous CO2 | Healthy adults and Patients with olfactory dysfunction due to PD | Unilateral nasal exposure 200 ms 145 mL/s | Trigeminal olfactory event related potentials were the same between healthy and PD individuals | None stated | Barz et al. 1997 | |
Eucalyptol | Healthy adults and Patients with olfactory dysfunction due to PD | Unilateral nasal exposure | Trigeminal sensitivity was the same in healthy and PD individuals | None stated | Tremblay et al., 2017 | ||
Healthy | nuroStym device at the right forehead and cheek | Healthy adults | 350 Hz 3.5 mA 10% DC 20 min | Slight decrease in creatine concentrations in the DLPFC region | None stated | Ritland et al. 2023 | |
Minimally Invasive Electroacupuncture, Supraorbital nerve | Healthy adults | 100 Hz 0.1—0.2 mA 0.25 ms PW 5 cycles of 1 min on 1 min off for 15 min | ↑ CBF in the prefrontal cortex ↑ Oxygenated Hb in PFC ↓ Deoxy Hb in R-PFC ↓ HR w/ EA | None stated | Suzuki et al. 2020 | ||
Ophthalmic nerve | Healthy adults | 120 Hz 30 s/min 30 min continuous | ↓ Mean olfactory detection threshold ↓ Sleepiness | None stated | Badran et al. 2022 | ||
Ophthalmic nerve | Healthy adults | 3 kHz 50 ms PW 30 s/min 20 min | No significant effect on learning | None stated | Arias et al. 2022 | ||
Opthalmic nerve + Transcranial Magnetic Stimulation | Healthy adults | 120 Hz 1.8–6.8 mA 0.25 ms PW 40 min | ↔ Cortical excitability | None stated | Axelson et al. 2014 | ||
Infraorbital nerve | 17 Healthy adults | 120 Hz 1 – 20 mA 0.25 ms PW 30 s on 30 s off for 20 min | ↓ R2 area ↔ R1 area ↔ R2 recovery cycle ↔ Intracortical excitability | None stated | Mercante et al. 2015 | ||
Infraorbital nerve | 20 Healthy adults | 120 Hz 1 – 20 mA 0.25 ms PW 30 s on 30 s off for 20 min | R2 blink response inhibited up to 60-min after TNS | None stated | Pilurzi et al. 2016 | ||
Infraorbital nerve | 18 Healthy adults | 120 Hz 1 – 20 mA 0.25 ms PW 30 s on 30 s off for 20 min | ↓ Beta-frequency intra- and interhemispheric coherences ↑ EEG frequency total power ↓ Interhemispheric gamma coherence | None stated | Ginatempo et al. 2018 | ||
Infraorbital nerve | 15 Healthy adults | 120 Hz 6 – 18 mA 0.25 ms PW 30 s on 30 s off for 20 min | ↓ Hand-blink reflex magnitude | None stated | Mercante et al. 2020 | ||
Supraorbital nerve | Healthy adults | 400 Hz Variable intensity | Blink potentiation for > 1 h | None stated | Mao and Evinger, 2001 | ||
Infraorbital nerve | Healthy adults | 120 Hz 1 – 20 mA 0.25 ms PW 30 s on 30 s off for 20 min | No significant increases in measured ERP components | None stated | Mercante et al. 2023 | ||
Trigeminal stimulation with gaseous CO2 | 12 normosmic and 11 anosmic | Not stated | Activation of cerebellum and premotor cortex, PFC, anterior cingulum, cingulate gyrus, insula | None stated | Iannilli et al 2007 | ||
CO2 trigeminal stimulation | 19 healthy | N/A | Activation of insula, middle frontal gyrus, and supplemental motor area, midbrain, DOFC, frontal operculum, superior temporal gyrus, medial frontal gyrus, and anterior caudate nucleus | None stated | Hummel et al 2005 | ||
Facial cooling | Healthy adults | N/A | ↓ HR | None stated | Janczak et al. 2022 | ||
Facial cooling | Healthy adults | N/A | ↑ CBV ↓ HR ↑ BP ↑ Coronary circulation | None stated | Prodel et al 2023 |